Development of the nursing home Resident Assessment Instrument in the USA.
BACKGROUND
the nursing home Resident Assessment Instrument (RAI) includes a set of core assessment items, known as the Minimum Data Set (MDS), for assessment and care screening and more detailed Resident Assessment Protocols in 18 areas that represent common problem areas or risk factors for nursing home residents. Its primary use is clinical, to assess residents on admission to the nursing home, at least annually thereafter and on any significant change in status and to develop individualized, restorative plans of care.


OBJECTIVE
to describe the content and development of the RAI, including US testing for MDS item reliability and validity of the RAI, and the results of a 4-year evaluation of the effects of its clinical use.


CONCLUSIONS
the evaluation found that implementation of the RAI was associated with significant improvements in a variety of measures of process quality, resident functional outcomes and reduced hospitalization. Other uses of the RAI data in the USA-including payment using resident classification systems and, with RAI-based outcome-oriented quality indicators, quality assurance activities-and the status of RAI use in other countries are also summarized.
Hawes
C
C
Research Triangle Institute, Research Triangle Park, NC, USA. MCH@rti.org
Morris
J N
JN
Phillips
C D
CD
Fries
B E
BE
Murphy
K
K
Mor
V
V
D000368:Aged; D004059:Diffusion of Innovation; D015577:Geriatric Assessment; D018166:Health Care Reform; D006801:Humans; D008403:Mass Screening; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D010347:Patient Care Planning; D016730:Program Development; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D014481:United States